Mammary Duct Ectasia Is a Benign Breast Condition

Woman having night sweats as duct ectasia is common at menopause
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Mammary duct ectasia is a benign (non-cancerous) condition in which the milk ducts become swollen and clogged, and occurs most commonly in women who are pre– or perimenopausal (age 40 – 50). When the milk ducts dilate and thicken, they become clogged resulting in the build up of fluid. Symptoms can include redness and pain in the nipple and surrounding area as well as a discharge that can be many colors including black or red. Duct ectasia may resolve on its own, but surgery is sometimes needed. Complications are uncommon but my include formation of an abscess when duct destruction is severe.

Mammary duct ectasia, also called periductal ectasia, is considered a non-proliferative condition and is not associated with an increased risk of breast cancer.

Symptoms

Duct ectasia can feel like a small lump just under your nipple. The nipple and areola may become tender and irritated, and turn pink or red. You may see thick, sticky discharge from your nipple, and this can be alarming as the nipple discharge is often sticky and dark green or black in color. The discharge may also be yellow, white, clear, or even grossly bloody. In some cases, the nipple may retract (pull inwards) with mammary duct ectasia, and this can be alarming as well as it is listed as one of the symptoms of breast cancer of which to be aware.

If an infection is present, a fever with or without chills may occur as well. With long standing duct ectasia, an abscess may form that can lead to an intermittent persistent fever.

Complications

While most episodes resolve on their own, in some cases the persistence of the condition results in the destruction of the breast ducts and formation of a breast abscess.

Causes and Risk Factors

Duct ectasia results from the normal changes that occur in breast tissues around menopause. The ducts become shorter and wider, increasing the chance that they will become clogged. Nipple inversion (sometimes due to an underlying breast cancer) can also result in duct ectasia, though much less commonly.

Risk factors including being menopausal, female (duct ectasia sometimes occurs in men but this is very uncommon), and smoking. That said, mammary duct ectasia has occurred in young children and older adults.

Diagnosis

Visit your doctor if you have duct ectasia symptoms that don't respond to self-care, or are painful. A breast ultrasound can often show the dilated breast ducts, though an MRI is sometimes needed. Mammography sometimes shows calcifications in the region.

When the diagnosis is uncertain, a biopsy (usually an excisional biopsy rather than a fine needle biopsy) is sometimes needed to be sure. After a biopsy, a pathologist looks at the sample under the microscope to make sure there is no evidence of cancerous cells present.

Treatment

Most of the time, mammary duct ectasia resolves without any treatment. Warm compresses may help the condition resolve and can also reduce discomfort. If there is evidence of an infection, antibiotics will be prescribed. It's important to not squeeze the area to increase discharge, as this will increase inflammation and the chance of an infection developing.

Much less often, surgery may be done to remove the duct, and usually does not change the appearance of the breast significantly. This procedure is called Hadfield's operation.

A Word From Verywell

Mammary duct ectasia can be uncomfortable, but fortunately is not associated with an increased risk of breast cancer or other complications. In some cases, surgery will be needed, but most resolve on their own in time. It's important to be your own advocate and talk to your doctor about what you may expect and what the next steps might be if your symptoms do not resolve within a particular amount of time. If you are watching your duct ectasia to see if it resolves, it's also important to call your doctor with any signs of an infection or an abscess, such as increased pain or a fever.

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